Valley fever 'epidemic': advice for providers

The senior citizen population is on the rise in the Southwest. Unfortunately, so is a frightening illness: valley fever.

“In recent years, valley fever numbers have soared so high that some health officials are calling it an epidemic,” NPR's Rebecca Plevin reported last week. “The Centers for Disease Control and Prevention says the total number of valley fever cases nationwide rose by nearly 900% from 1998 to 2011.”

An estimated 150,000 people get valley fever nationwide each year, and the illness is most common in the Southwest and California. From a senior care perspective, this is very alarming. The illness hits people older than 65 especially hard, and Arizona, Nevada, New Mexico and Utah all appeared on the “10 Fastest-Aging States” list published by the Huffington Post last Tuesday. Furthermore, these are popular vacation spots, and valley fever has been contracted by people just visiting this region.

Valley fever is a fungal disease, coccidioidomycosis. There is no cure or vaccine. Valley fever spores are located in the soil, and spread the disease when they are inhaled. Symptoms include fever, night sweats, headaches and chest pain. Skin rashes may appear. Most people exposed to the fungus do not get sick, according to a Centers for Disease Control webpage updated last week. However, a small number of people develop chronic pneumonia or meningitis, and the disease can be fatal. Researchers are not sure why some people are hit harder than others, or why the number of diagnosed cases has skyrocketed.

I was especially disturbed to learn that valley fever has ravaged two California prisons, where 34 inmates have died and more than 350 have been hospitalized with the illness since 2006. At the end of April, a state medical official directed that 3,000 high-risk inmates be relocated. The at-risk groups include Filipinos, African-Americans, those with compromised immune systems and those with chronic medical conditions.

If valley fever could take such a terrible toll in a prison environment, I shudder to think about an outbreak at a senior care center. Corey Egel at the California Department of Public Health provided some reassuring information: The illness does not spread from person-to-person contact.

“There is absolutely no evidence of valley fever spreading in such a manner,” he told me.

However, long-term care administrators should be aware of the signs and symptoms of valley fever, he said. Asking residents about possible sources of exposure, such as outdoor work or time spent in dusty environments, is also a good idea. Any identified cases should be reported to the local health department, Egel said.

Residents and care workers alike should be aware of their environment, as “fungal spores can get into the air when dirt containing the fungus is disturbed by digging, vehicle traffic, during construction or under strong winds,” according to Egel.

In addition to watching out for residents with valley fever symptoms and safeguarding environments against conditions favorable to the spread of spores, providers might also prepare to admit more and more people living with valley fever. The illness is controlled by anti-fungal medication that can have debilitating side effects. Todd Schaefer contracted valley fever a decade ago, and he is now losing his memory, NPR reported. His doctors believe he will experience seizures and strokes in the future.

The websites below contain more detailed information about valley fever, including resources for caregivers and those who have the illness:

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.